Suicide Grief Support Primer

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Introduction: Suicide Grief Support

Suicide Grief Support PrimerTABLE OF CONTENTS2 -How to Listen and Respond3-Common Survivor Experiences4-Reactions to Trauma5-Indicators for Professional Referral6-Survivors' Needs after the Crisis7-Survivors and Suicide Risk

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2015 Personal Grief Coaching, All Rights Reserved: This resource may be used in whole or in part without permission, but only for non-commercial purposes and as long as this copyright notice and permission statement accompany the material used.Page 2Based on: Hobfoll, S.E., Watson, P., Bell, C.C., Bryant, R.A., Brymer, M.J., Friedman, M.J., Ursano. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry. 70(4), 283315.How to Listen and Respond

(See 3Common Survivor Experiences Shock, feeling numb(from surviving a traumatic experience) Intense emotions (anger, irritability, shame, abandonment, sorrow) Distress over the question "Why?" (blame, continuously and painfully thinking about the death, denying that the cause is suicide) Guilt ("What did I do to cause this?" "I should have done more to prevent it.") Negative judgments or actions from other people because the death was a suicide Weakened support systems (people uncertain how to react to suicide, stressful family relations, social isolation) Relief (the death relieves family's difficulties, ends deceased's pain)

Note: Not all survivors experience all or any of these reactions.

Adapted from: Jordan, J. R., & McIntosh, J. L. (2011). Is suicide bereavement different? A framework for rethinking the question. In J. R. Jordan & J. L. McIntosh (Eds.),Grief after Suicide: Understanding the consequences and caring for the survivors (pp. 19-42). New York: Routledge.[Please also see thisbook review.]Page 4 Having distressing thoughts or images while awake or dreaming Feeling like the experience is happening all over again (a flashback) Avoiding talking, thinking, or having feelings about the event Avoiding reminders (triggers) of the event (people, places, and things connected to what happened) Reacting to (or beingtriggeredby) reminders of or feelings about the event (troubling thoughts or images, emotional or physical distress) Being "on the lookout" for danger, startling easily, being jumpy (hypervigilance) Having restricted emotions (e.g., feeling numb) Feeling detached or estranged from others (e.g., social withdrawal) Losing interest in usually pleasurable activities Having difficulty falling or staying asleep, problems concentrating or paying attention

Reactions to Traumatic ExperienceAdapted from: Brymer, M., Jacobs, A., Layne, C., Pynoos, R., Ruzek, J., Steinberg, A., Vernberg, E., & Watson, P., (2006). Psychological First Aid: Field operations guide (2nd ed.). National Child Traumatic Stress Network, Los Angeles & Durham, N.C.; National Center for PTSD, White River Junction, Vermont, 131133.Page 5Adapted from: SAVE. (2011). After a suicide: Coping with your grief. [Wallet card] Minneapolis, Minn.

Repeatedly experiencing loss of emotional control Feeling depressed or traumatized(see "Reactions," Page 4)for weeks with little or no relief Coping by using alcohol, drugs, or other risky or unhealthy means Having difficulty functioning in essential ways for days at a time (not taking care of personal hygiene, daily necessities, basic responsibilities

Note: These can be "normal" in traumatic grief, and decision making about seeking professional help should be guided by the severity and duration of symptoms.

Seek Professional Help: If a person is ...Page 6Survivors' Needs after the Crisis Help affirming or validating their sense of loss, especially through nonjudgmental listening and behavior Help anticipating emotional triggers and decreasing the intensity of reactions to trauma that disrupt daily functioning Help facing their grief in doses (instead of constantly) and finding ways to take a break from intense grief Help retelling the story of the death in a way that is safe and that shows compassion both for the deceased and for the survivor Help finding effective ways to manage changes in family dynamics and social relations -- and practicing what to say in particular situations Help exploring their continuing relationship with the deceased Help with activities to remember and honor the deceased Help returning to daily functions and looking toward the future Help identifying and engaging in culturally familiar and supportive sources of assistance for coping with their griefAdaptedfrom: Jordan, J.R. (2011). Principles of grief counseling with adult survivors. In J.R. Jordan & J.L. McIntosh (Eds.),Grief after Suicide: Understanding the consequences and caring for the survivors (pp.179223). New York: Routledge.[Please also see thisbook review.].Page 7It is important to remember that ... As a group, survivors are at a statistically higher risk of suicide. It is not uncommon for people who have lost a loved one to suicide to think about wanting to die, so it is vital to ask directly and clearlyif a person might take action on such thoughts. A survivor's wish to die might be for various reasons, for instanceTo escape from the pain of lossTo join the loved one in deathBecause of feeling unable orundeserving to live


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